As the average age of the overall population increases, so does the prevalence of vascular disease, principally arteriosclerosis. Although this disease is widespread, only in some cases will it progress to its advanced stages to threaten vital organ function or an extremity. When this occurs, patient care in the United States is generally provided by a diverse group of medical specialists who may have little interest and experience in the underlying disease process or its manifestations in other organ systems or other parts of the body. Because of this, vascular disease treatment and research is fragmented, taught poorly and without sufficient attention to prophylaxis and long-term management. The proposed application will use existing personnel and resources at Montefiore Medical Center/Albert Einstein College of Medicine: 1) to establish a Vascular Disease Management Center (VDMC) which formalizes existing relationships to form a multidisciplinary staff to optimally manage inpatients and outpatients with vascular disease; 2) to establish Integrated Educational Programs in Vascular Diseases for medical students, medical and surgical interns and residents,. medical and surgical nurses, medical practitioners and a variety of fellowship trainees; 3) to develop and facilitate Multidisciplinary Research in Vascular Diseases with core research facilities and participation from relevant basic scientists, clinicians, students and trainees; 4) to establish a two year Fellowship in Vascular Medicine which provides clinical exposure to all forms of treatment of vascular disease and participation in multidisciplinary research; and 5) to develop Standards for Vascular Disease Management which recognize the benign nature of most stages and forms of vascular disease as well as the adequately evaluated risks and benefits of various forms of noninterventional and interventional treatment.